Mr Gregory Bruce Jack, LPC in Plainfield, CT - Medicare Counselor Provider

Mr Gregory Bruce Jack, LPC is a medicare enrolled "Counselor - Professional" provider in Plainfield, Connecticut. His current practice location is 50 Academy Hill Road, Plainfield, Connecticut. You can reach out to his office (for appointments etc.) via phone at (860) 564-3015.

Mr Gregory Bruce Jack is licensed to practice in Connecticut (license number 000758) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164517512.

Contact Information

	Mr Gregory Bruce Jack, LPC
	50 Academy Hill Road, Plainfield, CT 06374
	(860) 564-3015
	(860) 564-3025

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Gregory Bruce Jack
Gender	Male
Speciality	Counselor - Professional
Location	50 Academy Hill Road, Plainfield, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164517512
Provider Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 1355784844
Enrollment ID: I20240212004009

Medical Identifiers

Medical identifiers for Mr Gregory Bruce Jack such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164517512	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	000758 (Connecticut)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Gregory Bruce Jack allows following entities to bill medicare on his behalf.

Entity Name	Day Kimball Healthcare, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649243478 PECOS PAC ID: 5092773549 Enrollment ID: O20041229001007

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Gregory Bruce Jack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Gregory Bruce Jack, LPC 50 Academy Hill Road, P.o. Box 201, Plainfield, CT 06374 Ph: (860) 564-3015	Mr Gregory Bruce Jack, LPC 50 Academy Hill Road, Plainfield, CT 06374 Ph: (860) 564-3015

Reviews and Comments

Counselor in Plainfield, CT

Eileen Blair, Counselor Medicare: Medicare Enrolled Practice Location: 50 Academy Hill Rd, Plainfield, CT 06374 Phone: 860-564-2323
Mrs. Maria A Gorby, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 Academy Hill Rd, Plainfield, CT 06374 Phone: 860-564-2323 Fax: 860-564-2696
Laurie Elaine Deslauriers, LADC/MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 16 High Meadow Dr, Plainfield, CT 06374 Phone: 860-334-5197
Gina Tourangeau, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 Academy Hill Rd, Plainfield, CT 06374 Phone: 860-917-9559

Mr Gregory Bruce Jack, LPC - Medicare Counselor in Plainfield, CT